Enhanced stroke rehabilitation outcomes through Information-Motivation-Behavioral skills model and Hospital-Community-Family ternary linkage integration: A randomized controlled trial.

BACKGROUND

Stroke remains a leading cause of disability and mortality globally, necessitating effective rehabilitation strategies to improve patient outcomes. This study aimed to evaluate the effectiveness of specialized routine nursing interventions, nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model, and nursing interventions combining the IMB model with a hospital-community-family triad model in patients with acute ischemic stroke.

METHODS

A total of 120 patients with acute ischemic stroke were randomly assigned to one of 3 groups: Control Group (specialized routine nursing interventions, n = 40), Experimental Group 1 (IMB model-based interventions, n = 40), and Experimental Group 2 (IMB model combined with hospital-community-family triad, n = 40). Clinical outcomes, including NIHSS scores, medication adherence, and functional exercise adherence, were assessed at discharge and 6 months post-intervention. Patient satisfaction was also evaluated.

RESULTS

No differences were noted between groups at baseline. Both IMB model-based interventions (Experimental Groups 1 and 2) significantly improved NIHSS scores, medication adherence, and functional exercise adherence compared to the Control Group at both discharge and 6 months post-intervention. The combined intervention (Experimental Group 2) yielded the most pronounced improvements. Patient satisfaction was highest in Experimental Group 2, followed by Experimental Group 1 and the Control Group. These improvements were greater in Experimental Group 2 than Group 1. The adjusted multivariate regression models indicated significant improvements in all measured outcomes for the experimental groups, with lower AIC and BIC values suggesting better model fit.

CONCLUSION

Nursing interventions based on the IMB model, particularly when combined with a hospital-community-family triad, significantly enhance clinical outcomes and patient satisfaction in stroke rehabilitation. These findings advocate for the integration of comprehensive, behavior-focused interventions in routine stroke care, addressing critical gaps in current rehabilitation practices. Future research should explore the long-term benefits and broader applicability of these interventions.